Sunday, December 30, 2012

Gastroenterology Top Stories of 2012

Gastroenterology Top Stories of 2012
A perspective on the most important research in the field from the past year
In keeping with our holiday tradition of highlighting the year's top stories from Journal Watch Gastroenterology, I have selected 10 stories that I believe will be of keen interest to all gastroenterologists. Here's a brief overview.

In the esophageal disease arena, we now know that endoscopic ablative therapies have become the standard of care in managing dysplastic Barrett esophagus, but incident cancers and recurrent dysplasia are being seen after successful complete ablation. Thus, continued surveillance of these patients is required. As for eosinophilic esophagitis, we can now add food elimination diets (e.g., dairy, wheat) to our therapeutic armamentarium.

With regard to colonic disease, we now have proof that we can prevent both distal and proximal colon cancer with high-quality colonoscopy, but high-quality colonoscopy requires an optimal bowel prep (split-dose, PEG-based) and skilled colonoscopic technique. Accomplishing colon cancer prevention is really in our hands — by performing careful, high-quality colonoscopy. Also, we now know that the best treatment for C. difficile colon infection is fecal transplantation. I eagerly await the release of a commercial preparation, which could transform this potentially debilitating and difficult disease into a mere nuisance for both patients and doctors alike.

When it comes to chronic pancreatitis, we have learned that smoking may be an equally important risk factor as alcohol, and our interventions should be aimed at both.

Finally, for liver disease, every year seems to bring major shifts in diagnostic and therapeutic advancements. This year is no exception, with emerging evidence that we are nearing an effective oral therapy for hepatitis C infection. Furthermore, although still unclear, it seems that screening for hepatocellular carcinoma in patients with chronic liver disease does result in improved outcomes.
Our gastroenterology top stories of 2012 are:

Ablative Therapy for Barrett Esophagus: Caveat Emptor
Esophagectomy Is Not Justified for Mucosal Neoplasia in Barrett Esophagus
Elimination Diet Works for Eosinophilic Esophagitis in Adults

Screening Colonoscopy Prevents Cancer in Both Proximal and Distal Colon
Split-Dose Colon Preparation Should Be Standard of Care
More Postcolonoscopy Cancers Attributable to Colonoscopic Versus Polyp Factors
Fecal Transplantation Effective for C. difficile Infection

Next-Generation Protease Inhibitor Effective for HCV Infection
Support for a 6-Month Surveillance Interval for Hepatocellular Carcinoma

Smoking Increases the Risk for Acute Pancreatitis

The year has taught us a lot, and I look forward to all we will learn in 2013.

As always, we count on your feedback in order to provide the most clinically relevant medical information to help you in your practices, so please send us your comments and suggestions at

Happy holidays to all of you.
M. Brian Fennerty, MD

Published in Journal Watch Gastroenterology December 28, 2012

No comments:

Post a Comment